Retrospective Study
Copyright ©The Author(s) 2023. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastrointest Surg. Aug 27, 2023; 15(8): 1693-1702
Published online Aug 27, 2023. doi: 10.4240/wjgs.v15.i8.1693
Accurate resection of hilar cholangiocarcinoma using eOrganmap 3D reconstruction and full quantization technique
Da-Peng Cui, Shuang Fan, Ying-Xue Guo, Qian-Wei Zhao, Yue-Xin Qiao, Jian-Dong Fei
Da-Peng Cui, Shuang Fan, Ying-Xue Guo, Qian-Wei Zhao, Yue-Xin Qiao, Jian-Dong Fei, Department of Hepatobiliary Surgery, The First Affiliated Hospital of Hebei North University, Zhangjiakou 075000, Hebei Province, China
Author contributions: Cui DP conceived this study, collected clinical data, interpreted the results, wrote, and revised the manuscript; Fan S, Guo YX participated in collecting data and data statistics; Zhao QW, Qiao YX, Fei JD participated in the study design and revised the manuscript; and All authors read and approved the final manuscript.
Supported by Key R&D Program of Hebei Province, No. 223777101D.
Institutional review board statement: This study was approved by the Medical Ethics Committee of The First Affiliated Hospital of Hebei North University.
Informed consent statement: All patients have signed the previous consent form before the surgery. According to institutional policy, this retrospective study does not require informed consent.
Conflict-of-interest statement: The authors declare no conflicts of interest for this article.
Data sharing statement: The data set used for this study can be obtained from the corresponding author.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Jian-Dong Fei, MM, Chief Physician, Department of Hepatobiliary Surgery, The First Affiliated Hospital of Hebei North University, No. 12 Changqing Road, Qiaoxi District, Zhangjiakou 075000, Hebei Province, China. feijiandong52@163.com
Received: April 11, 2023
Peer-review started: April 11, 2023
First decision: April 26, 2023
Revised: May 5, 2023
Accepted: June 13, 2023
Article in press: June 13, 2023
Published online: August 27, 2023
Processing time: 136 Days and 10.8 Hours
Abstract
BACKGROUND

For treatment of hilar cholangiocarcinoma (HCCA), the rate of radical resection is low and prognosis is poor, and preoperative evaluation is not sufficiently accurate. 3D visualization has the advantage of giving a stereoscopic view, which makes accurate resection of HCCA possible.

AIM

To establish precise resection of HCCA based on eOrganmap 3D reconstruction and full quantification technology.

METHODS

We retrospectively analyzed the clinical data of 73 patients who underwent HCCA surgery. All patients were assigned to two groups. The traditional group received traditional 2D imaging planning before surgery (n = 35). The eOrganmap group underwent 3D reconstruction and full quantitative technical planning before surgery (n = 38). The preoperative evaluation, anatomical classification of hilar hepatic vessels, indicators associated with surgery, postoperative complications, liver function, and stress response indexes were compared between the groups.

RESULTS

Compared with the traditional group, the amount of intraoperative blood loss in the eOrganmap group was lower, the operating time and postoperative intestinal ventilation time were shorter, and R0 resection rate and lymph node dissection number were higher (P < 0.05). The total complication rate in the eOrganmap group was 21.05% compared with 25.71% in the traditional group (P > 0.05). The levels of total bilirubin, Albumin (ALB) , aspartate transaminase, and alanine transaminase in the eOrganmap group were significantly different from those in the traditional group (intergroup effect: F = 450.400, 79.120, 95.730, and 13.240, respectively; all P < 0.001). Total bilirubin, aspartate transaminase, and alanine transaminase in both groups showed a decreasing trend with time (time effect: F = 30.270, 17.340, and 13.380, respectively; all P < 0.001). There was an interaction between patient group and time (interaction effect: F = 3.072, 2.965, and 2.703, respectively; P = 0.0282, 0.032, and 0.046, respectively); ALB levels in both groups tended to increase with time (time effect: F = 22.490, P < 0.001), and there was an interaction effect between groups and time (interaction effect: F = 4.607, P = 0.004). In the eOrganmap group, there was a high correlation between the actual volume of intraoperative liver specimen resection and the volume of preoperative virtual liver resection (t = 0.916, P < 0.001).

CONCLUSION

The establishment of accurate laparoscopic resection of hilar cholangiocarcinoma based on preoperative eOrganmap 3D reconstruction and full quantization technology can make laparoscopic resection of hilar cholangiocarcinoma more accurate and safe.

Keywords: eOrganmap; 3D reconstruction; Full quantification technology; Laparoscopic surgery; Hilar cholangiocarcinoma; Precise resection

Core Tip: The surgical resection rate of hilar cholangiocarcinoma (HCCA) is low, and the overall prognosis is poor. We analyzed 73 patients who underwent HCCA surgery using traditional 2D imaging planning or eOrganmap 3D reconstruction and full quantitative technical planning before surgery. By comparing the preoperative evaluation, anatomical classification of hilar hepatic vessels, indicators associated with surgery, postoperative complications, liver function, and stress response indexes of the two groups of patients, we resolved the problem of poor treatment.